Insulin-like growth factor-1 (IGF-1) is an important mitogenic factor, which has an intense role in promoting proliferation and anti-apoptosis, and is abnormally expressed in many malignant tumors. Aims: To investigate the expressions and clinical significance of IGF-1 and its receptor (IGF-1R) in patients with type 2 diabetes mellitus (T2DM) and gastric cancer (GC). Methods: A total of 338 patients with GC received surgery from Jan. 2010 to Jan. 2013 were enrolled, and were divided into GC group and GC-T2DM group. The expressions of IGF-1 and IGF-1R were detected by immunohistochemistry, and their relationship with clinicopathological parameters were analyzed. The effect of expressions of IGF-1 and IGF-1R on survival of patients was evaluated. Results: Compared with GC group, the positivity rates of IGF-1 (81.3% vs. 42.3%; χ2=31.427, P<0.001), IGF-1R (87.5% vs. 46.7%; χ2=34.794, P<0.001) were significantly increased in GC-T2DM group. The expressions of IGF-1, IGF-1R were related with the degree of tumor differentiation, lymph node metastasis and TNM staging in GC group (P<0.05). The expressions of IGF-1, IGF-1R were related with lymph node metastasis only in GC-T2DM group (P<0.05). Spearman's rank correlation analysis showed that there was a significant positive correlation between expression of IGF-1 and expression of IGF-1R in GC group, GC-T2DM group (P<0.05). No significant difference in survival rate was found between IGF-1 (-) group and IGF-1(+) group, IGF-1R(-) group and IGF-1R(+) group both in GC patients and GC-T2DM patients (P>0.05). Conclusions: Compared with GC patients, the positivity rates of IGF-1 and IGF-1R in GC-T2DM patients are significantly increased, and have certain negative effects on the clinicopathological parameters of the patients, suggesting that the two may promote the development and progression of GC through some mechanism.

Objective:To investigate the efficacy and safety of sindilizumab combined with apatinib in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma.Methods:A total of 74 elderly patients with recurrent and metastatic esophageal squamous cell carcinoma who were admitted to Xuancheng City Central Hospital from March 2019 to August 2020 were selected, and they were divided into study group and control group by random number table method, with 37 cases in each group. The control group was treated with apatinib mesylate, and the study group was treated with sindilizumab combined with apatinib mesylate. All patients were treated for 2 cycles and followed up for 1 year. The efficacy, peripheral blood tumor marker levels, adverse reactions and survival were compared between the two groups.Results:The objective response rate and clinical control rate in the study group were higher than those in the control group [35.1% (13/37) vs. 13.5% (5/37), 67.6% (25/37) vs. 43.2% (16/37)], and the differences were statistically significant ( χ2 = 4.70, P = 0.030; χ2 = 4.43, P = 0.035). After treatment, the levels of carcinoembryonic antigen (CEA), squamous cell carcinoma-associated antigen (SCC-Ag) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in the two groups were all lower than those before treatment (all P < 0.05); the levels of CEA, SCC-Ag and CYFRA21-1 in the study group were lower than those in the control group (all P < 0.05). There were no differences in the incidence rates of fatigue, proteinuria, bone marrow suppression, and hand-foot syndrome between the two groups (all P > 0.05). After 1 year of follow-up, 20 patients in the study group survived, and the 1-year overall survival (OS) rate was 54.1%; 10 patients in the control group survived, and the 1-year OS rate was 28.6%; the difference in OS between the two groups was statistically significant ( χ2 = 4.06, P = 0.044). Conclusions:Sintilimab combined with apatinib has a good efficacy in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma. This regimen can reduce the levels of tumor markers, improve the short-term survival rate of patients, and has good safety.